Toll Free: (888) 679-8181
Phone: (407) 679-8181
Fax: (407) 679-9300
*Your name
Name of your truck brokerage
*Mailing Address (PO Box or street, city, zip)
Physical Location (street - no PO Box - city, zip
The employer's federal tax ID number for your truck brokerage
*Home or office telephone
Cell phone
Fax number
*Email address
Your truck brokerage/property broker (MC) number
*Type of cargo that you broker most frequently and the percentage of time brokered? Please be as specific as possible and avoid terms like "general commodities" or "miscellaneous freight." An example of a correct response is 50% fruit and produce, 10% shrimp and other shellfish, 35% canned and dry grocery products, 5% paper products = 100%.
How did you hear about Hadley & Lyden, Inc.? (friend, magazine advertisement, internet search, or received a letter from Hadley & Lyden)
Names and titles of corporate officers or sole proprietor
*Year truck brokerage started
If your truck brokerage has been in business for less than 3 years, please describe prior experience of the principals in the truck brokerage or transportation industry.
*Estimated gross revenue of the truck brokerage for the next 12 months
*Do you want a quotation for TRUCK BROKERS LIABILITY (see description below)? Yes No
Limit of coverage requested?
*Do you want a quotation for GENERAL LIABILITY (see description below)? Yes No
Limit of coverage requested? $300,000 is the usual limit provided.
*Do you want a quotation for TRUCK BROKERS CARGO (see description below)? Yes No
Limit of coverage requested? $100,000 is the usual limit provided.
Does you or anyone with an ownership interest in the truck brokerage also own a tractor-trailer or have an ownership interest in a trucking company? Yes No
Name of the trucking company
DOT number of the trucking company
Name of the insurance company currently provide the vehicle liability and cargo insurance coverage for the trucking company
Are the trucking company and the truck brokerage operations located in the same building? Yes No
Do the trucking company and the truck brokerage operations have separate telephone numbers? Yes No
Do any employees of the trucking company also work for the truck brokerage? Yes No
Does your truck brokerage broker loads to your own trucking company? Yes No
Estimated gross revenue of the trucking company for the next 12 months?
1) Truck Brokers Liability - This coverage will protect the interest of a truck broker who is sued for bodily injury or property damage to a third party as the result of an accident involving a truck to which the truck broker has brokered a load. This policy is written specifically for the liability exposures of a truck broker and is not a general liability policy (which excludes liability coerage for vehicle acccidents). You may be familiar with the adverse consequences for truck brokers from the case C.H. Robinson Co. v. Schramm 8/23/04, in which the judge wrote "The broker's self-proclaimed status as a 'third party logistics company' providing 'one point of contact' service to its shipper clients is sufficient under the law to require the broker to use reasonable care in selecting the truckers whom it maintains in its stable of carriers" and "It cannot be ignored that C.H. Robinson increased the risk of harm to innocent third parties by its own actions." This insurance policy is designed to cover the cost of defense and judgments against the truck broker from this type of legal action. We offer a $300,000 limit with no deductible.
2) General Liability - This coverage will protect the interest of a truck broker who is sued for bodily injury or property damage to a third party as the result of the actions of the insured or his employees on the insured's prmises. While this policy excludes liability for vehicle accidents, it is the type of coverage most often requested by shippers. We offer a $1,000,000 limit.
3) Truck Brokers Cargo - This will cover loss or damagae to cargo on brokered loads caused by fire, upset, collision, theft by a third party (other than a driver or owner of a truck), jackknife, and other named perils. It includes coverage for unreimbursed advances, in connection with a cargo loss that is paid under this policy. We offer a $100,000 limit with a $2,500 deductible. Higher limits are available upon request.
* Required
